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Diuretics cardiac surgery

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https://www.readbyqxmd.com/read/28706743/when-is-the-optimal-timing-of-surgical-intervention-for-severe-functional-tricuspid-regurgitation
#1
Nobuhiro Nakanishi, Masanobu Ishii, Koichi Kaikita, Ken Okamoto, Yasuhiro Izumiya, Eiichiro Yamamoto, Seiji Takashio, Seiji Hokimoto, Toshihiro Fukui, Kenichi Tsujita
Functional tricuspid regurgitation (TR) is a serious pathology to be noted for severe right heart failure (HF) and poor prognosis; however, the conventional assessment of TR has some limitations and the optimal timing of surgical intervention remains unclear. A 79-year-old Japanese female was admitted to our hospital to undergo cardiac surgery, because edema gradually got worse despite the increase in diuretics. She had a history of atrial fibrillation (AF) and chronic HF due to severe TR and had been treated with a furosemide for leg edema 4 years ago...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28612323/risk-assessment-and-outcomes-of-vasoplegia-after-cardiac-surgery
#2
Athanasios Tsiouris, Lynn Wilson, Ala S Haddadin, James J Yun, Abeel A Mangi
OBJECTIVE: The aim of this study was to analyze risk factors and outcomes of vasoplegia after cardiac surgery based on our experience with almost 2000 cardiac operations performed at our institution. METHODS: We retrospectively analyzed patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) between 2011 and 2013. Data were available for a total of 1992 patients. We defined vasoplegia as hypotension with persistently low systemic vascular resistance (<800 dyn/s/cm) and preserved Cardiac Index (>2...
June 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#3
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#4
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28499652/lack-of-furosemide-responsiveness-predicts-acute-kidney-injury-in-infants-after-cardiac-surgery
#5
Aadil Kakajiwala, Ji Young Kim, John Z Hughes, Andrew Costarino, John Ferguson, J William Gaynor, Susan L Furth, Joshua J Blinder
BACKGROUND: This was a retrospective study to determine whether lack of furosemide responsiveness (LFR) predicts acute kidney injury (AKI) after cardiopulmonary bypass surgery in infants. METHODS: Infants (less than 1 year of age) undergoing cardiopulmonary bypass surgery, receiving routine postoperative furosemide (0.8 to 1.2 mg/kg per dose between 8 and 24 hours after surgery) were included. Urine output was measured 2 and 6 hours after furosemide dose. Lack of furosemide responsiveness was defined a priori as urine output less than 1 mL · kg(-1) · h(-1) after furosemide...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28496931/safety-of-the-direct-oral-anticoagulant-edoxaban-for-atrial-fibrillation-after-cardiac-surgery-pilot-study
#6
Akira Sezai, Shunji Osaka, Hiroko Yaoita, Munehito Arimoto, Hiroaki Hata, Motomi Shiono
Direct oral anticoagulants have recently been recommended for non-valvular atrial fibrillation, but have rarely been studied in the field of cardiac surgery. We prospectively investigated the safety of edoxaban, a novel oral anticoagulant, for use in cardiac surgery patients with postoperative atrial fibrillation (POAF), which is the most common complication of cardiac surgery and can lead to stroke. The subjects were adult cardiac surgery patients with POAF who received oral edoxaban for 2 months in an open-label pilot study...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28495809/comparison-of-enteral-versus-intravenous-potassium-supplementation-in-hypokalaemia-in-paediatric-patients-in-intensive-care-post-cardiac-surgery-open-label-randomised-equivalence-trial-eips
#7
Naveed Ur Rehman Siddiqu, Quratulain Merchant, Babar S Hasan, Arjumand Rizvi, Muneer Amanullah, Amina Rehmat, Anwarul Ul Haq
OBJECTIVES: The primary objective was to compare the efficacy of enteral potassium replacement (EPR) and intravenous potassium replacement (IVPR) as first-line therapy. Secondary objectives included comparison of adverse effects and number of doses required to resolve the episode of hypokalaemia. TRIAL DESIGN: The EIPS trial is designed as a randomised, equivalence trial between two treatment arms. STUDY SETTING: The study was conducted at the paediatric cardiac intensive care unit (PCICU) at Aga Khan University Hospital, Karachi...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28475712/surgical-management-of-aortopulmonary-window-24-years-of-experience-and-lessons-learned
#8
Deepak Gowda, Trushar Gajjar, Jinaga Nageswar Rao, Praveen Chavali, Aaditya Sirohi, Naveen Pandarinathan, Neelam Desai
OBJECTIVES: Aortopulmonary window represents 0.2-0.3% of all congenital heart lesions. Progressive pulmonary arterial hypertension and its consequences are more common with this anomaly. The purpose of this study was to share 24 years of surgical experience in managing a spectrum of 55 cases of aortopulmonary window, followed up to 17 years in a single institution. METHODS: : This retrospective study was done from November 1991 to November 2015 of 55 patients with aortopulmonary window who underwent successful surgical repair...
May 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28449477/continuous-administration-of-recombinant-human-b-type-natriuretic-peptide-can-improve-heart-and-renal-function-in-patients-after-cardiopulmonary-bypass-surgery
#9
Shiguan Le, Jian Xiao, Wei Li, Jing Wang, Qing Wang, Wang Xi, Jibin Xu, Zhinong Wang
BACKGROUND: Any cardiac surgery under cardiopulmonary bypass (CPB) will induce ischemia-reperfusion injury and systematic inflammatory response, which may lead to exacerbation. Conventional therapy strategy is to use inotropes, diuretics and vasodilator drugs, yet, the therapeutic effects of which need to be improved. Recombinant human B-type natriuretic peptide (rhBNP) has been shown to be efficacious in the treatment of acute decompensated heart failure and acute myocardial infarction...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28410819/-remifentanil-does-not-increase-urine-output-during-oral-surgery-contrary-to-its-effect-during-other-surgeries-a-cohort-study
#10
Kentaro Ouchi, Kazuna Sugiyama
BACKGROUND: An increase in urine output by remifentanil injection during laparoscopic procedures and surgeries such as cardiac and gynecological procedures, due to suppression of the stress response to surgery, has been reported. The aim of our prospective, observational, cohort study was to assess the effect of remifentanil analgesia on urine output during dental and minor oral surgery by comparing intraoperative urine output under defined infusion volumes with and without the use of remifentanil...
April 11, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28396860/aortic-valve-replacement-for-moderate-aortic-stenosis-with-severe-calcification-and-left-ventricualr-dysfunction-a-case-report-and-review-of-the-literature
#11
Nikhil Narang, Roberto M Lang, Vladimir M Liarski, Valluvan Jeevanandam, Marion A Hofmann Bowman
A 55-year-old man with a history of erosive, seropositive rheumatoid arthritis (RA), and interstitial lung disease presented with shortness of breath. Echocardiography showed new-onset severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 15% and moderately increased mean aortic valve gradient of 20 mmHg in a trileaflet aortic valve with severe sclero-calcific degeneration. Coronary angiography revealed no significant obstructive coronary disease. Invasive hemodynamic studies and dobutamine stress echocardiography were consistent with moderate aortic stenosis...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28389482/what-are-the-risks-and-benefits-of-temporarily-discontinuing-medications-to-prevent-acute-kidney-injury-a-systematic-review-and-meta-analysis
#12
Penny Whiting, Andrew Morden, Laurie A Tomlinson, Fergus Caskey, Thomas Blakeman, Charles Tomson, Tracey Stone, Alison Richards, Jelena Savović, Jeremy Horwood
OBJECTIVES: To summarise evidence on temporary discontinuation of medications to prevent acute kidney injury (AKI). DESIGN: Systematic review and meta-analysis of randomised and non-randomised studies. PARTICIPANTS: Adults taking diuretics, ACE inhibitors (ACEI), angiotensin receptor blockers (ARB), direct renin inhibitors, non-steroidal anti-inflammatories, metformin or sulfonylureas, experiencing intercurrent illnesses, radiological or surgical procedures...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28382621/spironolactone-effect-on-potassium-supplementation-in-paediatric-cardiac-intensive-care-patients
#13
B S Moffett, T E Haworth, Y Wang, N Afonso, P A Checchia
WHAT IS KNOWN: Spironolactone is used in paediatric patients with heart disease, yet few data are available regarding the impact on potassium supplementation. OBJECTIVE: We sought to determine the effect of spironolactone on potassium supplementation in paediatric cardiac intensive care patients. METHODS: A retrospective, propensity matched cohort study was designed. Patients were included in the study if they received furosemide therapy in the cardiac intensive care unit at our institution...
April 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28370213/left-ventricular-basal-inferior-pseudoaneurysm-and-left-atrial-dissection-after-myocardial-infarction-case-report
#14
Rui Azevedo Guerreiro, Kisa Congo, João Carvalho, João Pais, Diogo Brás, Bruno Piçarra, Agostinho Caeiro, José Aguiar
Left atrial dissection is a rare entity, mostly occurring after mitral valve surgery, with only a few cases described after myocardial infarction. The authors report a case of a 60-year-old man who presented with an inferior myocardial infarction, complicated with pseudoaneurysm of basal segment of left ventricular inferior wall, which expanded through the mitral ring to left atria, causing left atrial free wall dissection. The left ventriculo-atrial communication through the pseudoaneurysm caused major para-mitral regurgitation and the development of acute heart failure...
March 31, 2017: Echocardiography
https://www.readbyqxmd.com/read/28241247/peritoneal-dialysis-vs-furosemide-for-prevention-of-fluid-overload-in-infants-after-cardiac-surgery-a-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
David M Kwiatkowski, Stuart L Goldstein, David S Cooper, David P Nelson, David L S Morales, Catherine D Krawczeski
Importance: Fluid overload after congenital heart surgery is frequent and a major cause of morbidity and mortality among infants. Many programs have adopted the use of peritoneal dialysis (PD) for fluid management; however, its benefits compared with those of traditional diuretic administration are unknown. Objective: To determine whether infants randomized to PD vs furosemide for the treatment of oliguria have a higher incidence of negative fluid balance on postoperative day 1, as well as avoidance of 10% fluid overload; shorter duration of mechanical ventilation, intensive care unit stay, and inotrope use; and fewer electrolyte abnormalities...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/27956671/defining-oliguria-during-cardiopulmonary-bypass-and-its-relationship-with-cardiac-surgery-associated-acute-kidney-injury
#16
D Hori, N M Katz, D M Fine, M Ono, V M Barodka, L C Lester, G Yenokyan, C W Hogue
BACKGROUND: While urine flow rate ≤0.5 ml kg(-1) h(-1) is believed to define oliguria during cardiopulmonary bypass (CPB), it is unclear whether this definition identifies risk for acute kidney injury (AKI) . The purpose of this retrospective study was to evaluate if urine flow rate during CPB is associated with AKI. METHODS: Urine flow rate was calculated in 503 patients during CPB. AKI in the first 48 h after surgery was defined by the Kidney Disease: Improving Global Outcomes classification...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27875721/percutaneous-mitral-valve-repair-the-last-chance-for-symptoms-improvement-in-advanced-refractory-chronic-heart-failure
#17
Alessandra Berardini, Elena Biagini, Francesco Saia, Davide Stolfo, Mario Previtali, Francesco Grigioni, Bruno Pinamonti, Gabriele Crimi, Alessandro Salvi, Maurizio Ferrario, Antonio De Luca, Fabrizio Gazzoli, Maria Letizia Bacchi Reggiani, Claudia Raineri, Gianfranco Sinagra, Claudio Rapezzi
BACKGROUND: The role of percutaneous mitral valve repair (PMVR) in patients with end-stage heart failure (HF) and functional mitral regurgitation (FMR) is unclear. METHODS: Seventy-five consecutive patients with FMR grade≥3+ and severe HF symptoms despite optimal medical therapy and resynchronization therapy underwent PMVR with the MitraClip system (Abbott, Abbott Park, IL, USA) at 3 centers. Clinical evaluation, echocardiography and pro-BNP measurement were performed at baseline and at 6-month...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27855469/right-sided-heart-failure-and-extracorporeal-life-support-in-patients-undergoing-pericardiectomy-for-constrictive-pericarditis-a-risk-factor-analysis-for-adverse-outcome
#18
Erik Beckmann, Issam Ismail, Serghei Cebotari, Alexander Busse, Andreas Martens, Malakh Shrestha, Christian Kühn, Axel Haverich, Christine Fegbeutel
Background Right ventricular failure is a life-threatening postoperative complication after pericardiectomy. We conducted a retrospective study with a special emphasis on right ventricular failure. Methods Between June 1997 and September 2011, 69 patients underwent surgical pericardiectomy at our center. Mean age was 59 ( ±  15.5) years, and 49 (71%) patients were male. Causes of constrictive pericarditis included idiopathic (52%, n = 36), tuberculosis (9%, n = 6), postcardiotomy (12%, n = 8), radiation (4%, n = 3), renal insufficiency (12%, n = 8), and autoimmune disease (12%, n = 8)...
November 17, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27834164/efficacy-of-sequential-nephron-blockade-with-intravenous-chlorothiazide-to-promote-diuresis-in-cardiac-intensive-care-infants
#19
Brady S Moffett, Rocky Tsang, Curt Kennedy, Ron A Bronicki, Ayse Akcan-Arikan, Paul A Checchia
BACKGROUND: Sequential nephron blockade using intravenous chlorothiazide is often used to enhance urine output in patients with inadequate response to loop diuretics. A few data exist to support this practice in critically ill infants. METHODS: We included 100 consecutive patients <1 year of age who were administered intravenous chlorothiazide while receiving furosemide therapy in the cardiac ICU in our study. The primary end point was change in urine output 24 hours after chlorothiazide administration, and patients were considered to be responders if an increase in urine output of 0...
November 11, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#20
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
January 2017: Pediatric Cardiology
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